How to smooth out crepey skin under the eyes? Are Botox/fillers the answer? (photos)

Fractional laser is an amazing and highly effective treatment in our office. We use the laser treatment to help with acne scars, large pores, fine wrinkles, tissue collagen loss, scars, sebaceous hyperplasia, active acne, and for brightening dark pigmentation. Although there are very strong fractional lasers such as CO2 laser, we use lighter treatments for corrective skincare and maintenance of results. Our Thulium fractional laser, clear and brilliant laser, and Ultra Thulium laser are excellent options in our clinic. We also perform CO2 fractional and erbium depending on skin tone and tolerance for downtime. Patients do have to use a Melarase cream before and after treatment to help further reduce pigmentation after laser. Melarase AM, Melarase PM, and Melapads can seriously improve surface sun damage and UV related pigmentation. Dark spots can improve with these treatments. I recommend fractional laser for incisional scars as well, especially after plastic surgery.
Best,
Dr. Karamanoukian
Realself100 Surgeon

Thanks for your question. Did you receive Botox or fillers in the tear trough area? Depending on what product was injected, the expected result would differ. Botox helps to smooth fine lines and wrinkles by reducing the activity of certain facial muscles. Typically Botox is injected in the forehead, glabella, or crows feet however it can be used in other areas as well. Fillers are often used in the tear duct area to help restore volume. This often reduces the appearance of under-eye bags and fine lines that are due to volume loss. If you aren't completely satisfied with the results of your recent treatment, I recommend scheduling a follow up appointment with your provider so that they can address your concerns in person.

There are many options available to treat and tighten skin beneath the eyes. Sometimes filler injections like Volbella or using your own fat as a filler can create a smooth convex appearance in this area. TCA chemical peels and fractional CO2 lasers work well. A skin pinch blepharoplasty is a surgical option. Botox is only useful to treat "dynamic" wrinkles... wrinkles in motion. Good luck

Chemical peels are great for around the eyes as well as the whole face. Of coarse, botox, lasers and fillers are helpful also but chem. peels are inexpensive and do so much for the skin that everyone needs at least yearly peels to keep their skin its best.

A combination approach will give the most improvement. Fillers, lasers, and microneedling/PRP can improve under the eyes. My patients try to get non surgical treatments to avoid surgery. We use PRP and stem cells there often. I suggest consulting with an expert to develop a treatment plan best suited for your short and long term goals. Best, Dr. Emer

Thank you for your question. Fillers and Botox are not used to treat crepe skin under the eye. Fillers are used to add volume in the lower eye area (tear troughs). Crepe skin in this area is better treated with either laser or chemical resurfacing. Also, surgery is not option for crepe skin. I recommend having a consultation with an expert to discuss your concerns and to determine the best treatment plan for you. Best of Luck!

I will use Botox (2 units per side) under the eye if crepy skin is the problem; laser resurfacing can also help with crepy skin. If there is a deep tear trough (e.g. with shadowing), then putting in filler makes sense. Your dermatologist can guide you as to the best treatment option in your case.

Thank you for
your question kslivingstone. Botox is a
purified protein used to address wrinkles associated with facial expression. Fillers can be placed in the tear trough to restore lost volume. Each injector does his/her own technique. It is important to look for results, not the technique used. If I had a patient who looked like the person in these photographs I would say she is a good candidate for fractional CO2 laser resurfacing around the eyes. Please consult
with a doctor for specific recommendations. Good luck!

You were misled. CO2 laser resurfacing is the best method for smoothing out wrinkles of this type. But this, like most procedures, is only as good as the experience and skill of the doctor performing the procedure.

klivingstone,The skin in the lower lid area is very thin and delicate and often a place where fine lines and wrinkles first appear.  Fillers will help decrease the appearance of the under eye facial hollows.  Crepey skin is best addressed with resurfacing techniques that smooth out skin such as chemical peels and lasers.  Since you are only 3 days out, be patient in evaluating your outcome since some of the under eye puffiness may be due to swelling.  Best of luck!Dr Edween